NCG180034_Renewal COC Request_20191031 1:13:49 PM

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NORTH CAFOLINA
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Permit COC
NCG180034
Number *
Enter the Certificate of Coverage (COC) number, not the General Fbrmt number (e.g., NCGO30222 is the COC, not
NCG030000) M-ST BEGIN WTTH CAPRAL "NCG'
Name of Person
Toddrey Curlee
Obtaining COC*
First and LastNarre
Phone Number* 704-474-3184
Email * [e-mail]
The COC will be e-rrailed to this contact.
Additional Email [e-mail]
(Optional) Enter an additional email address to whom to send the COC
Please review the information below for accuracy before submitting. If there are inconsistencies, please
contact Bethany Georgoulias at [phone] or [e-mail].
Master General NCG180000
Permit No.
COC No.
NCG180034
Permittee
Stanly Fixtures Acquisition LLC
Facility Name
Stanly Fixtures Acquisition LLC
Address
11635 NC 138 Hwy
City
Norwood
County
Stanly
Waterbody
Alligator Branch
Classification
C
River Basin
Yadkin
RENEWAL STATUS
Active
Issuance Date*
08/01/2019
Effective Date
08/01/2019
1 hereby request a copy of the Certificate of Coverage (COC) entered above. I understand that the COC e-mailed as a
result of this request will serve as the Permittee's record of renewed coverage under the General Permit, and that this
record must be maintained with the Permittee's NPDES Stormwater Permit records.
Signature

Date * 10/31 /2019